Teen daughter, no periods, GP blaming weight?

[mumofteenss]

My 16 year old DD has had 5 periods since she started her periods 4.5 years ago. When she got her first period she was of normal weight and height. She gained some weight in the first few years of high school when she quit sports clubs she had done when younger, She was considered overweight a year after her first period and not having a second. Now her weight is at the upper end of normal and has been for around another year, but it has been 18 months since her last period. Her BMI, though not always an accurate determine healthy weight i know, is 24.2, she looks in proportion and doesnt appear overweight. I have taken her to the GP numerous times, she has had blood tests, and an ultrasound for PCOS, these came back normal, bar testosterone which was high. GP is refusing any further investigation, and blaming her weight. She has basically said my daughter needs to lose weight and her periods will "kick in".

AIBU to think there has to be a medical reason as to how a teenage girl can only have had 5 periods in 4.5 years and want her to have some answers regarding future fertility etc now?

When she started her periods she started a tracker, so we can see he had a period June 2020, Aug & Sept 2021, Feb & March 2022, March 2023. She has no spotting between. She also suffers quite badly with acne. Any suggestions would also be appreciated. We have seen the GP atleast 10+ times regarding this issue over the years.

She is aware i am posting here for advice and was happy for me to share this information.

Your GP sounds HORRIFIC! Telling a teenage girl with a healthy BMI to lose weight is disgusting and could do so much damage.

Can you take your daughter to a well woman clinic or similar? They might be able to help or give the appropriate referrals.

I would see a different GP and ask for a gynaecologist referral or else see if you can see one privately.

I would ask to be referred to a gynae. I could speculate on PCOS but she needs to be seen by a specialist and that’s what you need to ask. Don’t ask the GP for their opinion say you wish to see someone who can investigate with a specialist background. Or change GP

PCOS isn’t just a scan to diagnose, I don’t have it on a standard ultrasound but I still have it

Make sure she gets her prolactin levels checked to rule out a prolactinoma. I had this condition, my periods had a similar pattern to your DD’s and it took ages to be diagnosed.

Why aren't they investigating the hormone imbalance? High testosterone could be indicative of something that needs treatment. Is she shorter than expected? My niece was very similar and didn't start periods till she was 17 after intervention. She's a proud mum now, but having her kid destroyed what little bone density she had, and at 30 she officially has osteoporosis. Your daughter needs checked out

I second the gynae suggestion. Are you in a position to see one privately.

I am shocked at what the GP said. Please do not take her to see them again.

This definitely sounds like PCOS or a hormonal issue to me. My DD gained weight, had bad acne and irregular periods as a teenager and was diagnosed with PCOS later. You need to see another GP I think and definitely consider seeing a gynaecologist privately if you don’t get any further with them.

Find a new GP and keep on doing so until one will listen.

I was diagnosed with PCOS at 18 many years ago, after several years of a GP fobbing me off. I went through years of misery until I was diagnosed and prescribed the pill etc which transformed my life (no exaggeration, I went through hell). I have absolutely no tolerance for GP’s etc who fob teens and women off with period concerns. Keep going until you find someone who will listen.

Was this an external or internal ultrasound scan? I think external ones miss loads of gynae issues.

Change her doctor. Or go private.

Please see a different GP or ask for the high testosterone to be investigated, that could be why. I remember my periods started off erratically but one a year is worthy of investigation. Women’s health is dismissed all the time and it takes on average 8 years to get diagnosis of endometriosis - I hope you can be taken seriously sooner than that

as per pp def sort out another GP. Speak to the receptionist and ask them to direct you to one with a gynae speciality.

unless you can afford private another option may be just to pay for the blood test. It’s relatively inexpensive and you can get anything from basic hormone panel to everything covered. The one we had includes a dr review and they flag anything that needs further investigation. Then you have the lab report to kick them up the arse.

I would suspect PCOS.

With me they started with a blood test. As the blood test had some indicators for PCOS, they did an internal scan, which confirmed the diagnosis.

As she is not chubby, she may have been born with it. In which case, losing weight will not bring back the periods but it will diminish some of the symptoms of PCOS such as facial hair. ( And my parents used to nag me about being skinny. I am very happy that I was. Otherwise, I might have had a moustache now).

A little known fact about PCOS is that if you get very overweight you will get diabetes. Not maybe or if. So losing weight is a good idea if she does have PCOS regardless of the reason why it appeared in the first place.

I'm never normally one to tell people to complain about GPs but please think about complaining. Completely wrong, potentially missing an issue which needs investigating and giving a healthy teenager disordered eating to boot. Disgusting.

Thanks for the replies. The ultrasound was external, and tbh, im not sure how good an image they got. She had drank her litre of water an hour before her appointment, then when we booked in continued to drink more as advised. Only for the appointment to be 45 minutes late, by which time she was in tears as she was so desperate for the toilet, she couldnt lay still, and they got the images in under 3 minutes despite it being a 20 minute appointment slot? Is is worth me pushing to put her through an internal scan?

The bloods she has had previously, were the testosterone LH and FSH. There may have been others included but they are the ones that they mentioned when i called for results, and the said the LH and FSH were within range. What bloods should i be pushing for?

Private is not an option at the moment unfortunately, but something i could save for if that would be the best route.

On the surface of it that doesn't sound great. I'm a GP - if you were going to tell me that your daughter had a BMI of 35 it might well be appropriate advice, but not at 24! I would hope prolactin had been done as part of the tests, but I'd be getting advice from gynae/referring with this picture.

PCOS is the most likely cause, especially with high testosterone. The ultrasound scan can be normal with PCOS as can the hormones.

Weight control is important - I know she is not technically overweight but if she reduced carbs and lost some then her hormones would most likely improve and her cycle might return to normal.

Triggering a bleed artificially with progesterone would be a good idea - might help with cycle but even if not it is important to have the odd period to keep the lining of the womb healthy. About four per year is what the Gynaecologists usually suggest.

SHBG is a useful blood test for PCOS - sex hormone binding globulin

Please look into this.

https://my.clevelandclinic.org/health/diseases/23096-kallmann-syndrome

I have it, diagnosed at age 19 after years of doctors telling me I was anorexic and that’s why I had no periods. I wasn’t anorexic at all, I just hadn’t fully started puberty. My breasts started to grow, then stopped, I had public hair ect but no periods. Some do get periods but then they stop. Check her bone density as well, well ask the doctors to do that. Years of insufficient sex hormones (if that’s what’s happening ) causes deterioration in bone density. I have no family history of this, it’s extremely rare.

Oh and forgot to mention, I had scans and my uterus etc all fine and am expecting my first baby through ivf. It’s an endocrine condition, not a physical problem as all my lady bits are intact inside and out.

could you try get a referral to an endocrinologist?

how is her sense of smell? That’s a symptom of kallmans but if she can smell it could be this https://medlineplus.gov/ency/article/000390.htm

The cause of mine is likely a genetic mutation

I was of normal weight very active but never had periods - once every 6-9 months - then in the end was diagnosed with PCOS c17 yrs old. ultimately it was improving my eating that got me back on track. I was size 10, 5’7’’ but ate as many sweets and fast food as I could. Literally within a month of going to a Mediterranean style diet where I cut out processed bread, sugar, chocolate, dairy, and instead ate tons of vegetables, beans, and a bit of lean meat, and I was completely regular.

Be careful about looking for an illness label, even PCOS, that means you start thinking that doing something about this is outside of your control or needs medicating. Ultimately most things hormone related can be managed with diet, including things like endometriosis. But people have to be very disciplined about it. Most of us aren’t!

I was very overweight as a child, started my periods at 11 and was regular from the start. I don't that has anything to do with it.

It's possible the sports had an effect if she was very into those as they do stop periods if a lot. Not sure how long the effect lasts after stopping though.

Agree need a different GP.

Have you looked at her diet? High sugar and glucose spikes can be a cause of acne, also is she suffering with stress, is anything happening in her life which is causing stress as this can be a major cause of period problems, also look at introducing exercise, make sure drinking plenty water & have eight hours sleep. Sometimes things like this are often over looked, but can make the biggest changes.

It's not a label FFS

Would you say you're looking for an illness label if someone had cancer?

How am I meant to get my ovaries untied from where they are with diet? They're tied together with scar tissue, I have stage 4 endometriosis and adenomyosis, it needs surgery

If someone had spotted it earlier then I might be ok now rather than in agonising pain

Her weight alone would not make periods that sporadic. Plus she's not even overweight!
Speak to a senior female GP and ask for a referral to women's health/gynae.
That GP sounds very dismissive and quite unprofessional. Maybe if she was morbidly obese you could see their angle, but it needs further investigation I would've thought.